Provider Demographics
NPI:1093356123
Name:GUENTHNER, ERICA (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GUENTHNER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 OAK RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2625
Mailing Address - Country:US
Mailing Address - Phone:781-626-0474
Mailing Address - Fax:
Practice Address - Street 1:24 LYMAN ST STE 300
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1484
Practice Address - Country:US
Practice Address - Phone:508-366-7100
Practice Address - Fax:508-366-7303
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289399207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine